Healthcare Provider Details

I. General information

NPI: 1740841493
Provider Name (Legal Business Name): COMPASSIONATE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 06/19/2021
Certification Date: 06/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 S IDA ST
WICHITA KS
67216-1353
US

IV. Provider business mailing address

2828 S IDA ST
WICHITA KS
67216-1353
US

V. Phone/Fax

Practice location:
  • Phone: 316-409-7724
  • Fax:
Mailing address:
  • Phone: 316-409-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MONDAY T AKINTUYI
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 316-409-7724